Substance Use
Learning about how to give naloxone if you think someone has opioid poisoning
Opioid poisoning (overdose) happens when you take more of an opioid than your body can handle. This can stop your brain, heart, and lungs from working. Naloxone is a medicine that stops opioid poisoning.
Signs of an opioid poisoning
- slow or no breathing
- others can’t wake you by talking loudly or with a painful touch
- trouble walking, talking, or staying awake
- for lighter skin tones: skin, nails, and lips appear blue
- for darker skin tones: skin, nails, and lips appear grey
- gurgling or snoring sounds
- choking or vomiting
- cold or damp skin
- tiny (constricted) pupils
- looking stiff or having seizure-like movements
How to prevent opioid poisoning
- Don’t use opioids alone.
- Use in a place you know and take your time.
- Use a test dose.
- Know your health and how much opioid your body can handle.
- Don’t mix opioids with other substances.
- Know that taking opioids by mouth or by snorting can be less harmful than smoking (inhaling) or injecting them.
- Know the signs of opioid poisoning.
- Carry a naloxone kit. Know how to use it and call 911.
- Know where to get support and resources on substance use, treatment, and recovery.
Important points about giving naloxone
- It only works on opioids.
- It’s safe to give to anyone at any age. Always call 911 if you give naloxone to a child or someone who’s pregnant.
- Naloxone starts working in 2 to 5 minutes.
- Naloxone works for about 20 to 90 minutes. Poisoning can happen again once naloxone wears off.
- The safety needle that comes in naloxone kits will pop into the syringe after you inject it. This means you won’t see the needle when you take it out. This helps prevent a needlestick injury.
- Naloxone will expire. Check the expiry date on the vials and the sticker on the back of your kit.
- Keep naloxone away from light at a temperature between 15°C to 30°C.
- Get a new naloxone kit if the kit you have expires or gets too hot or too cold. If this kit is the only one you have, you should still use it if you need to. It may not work as well, but it may still save someone’s life and won’t cause harm.
Opioid poisoning response steps
If you think someone has opioid poisoning and you need to give naloxone, make sure you are safe first.
If you’re in an unsafe place or there are dangerous things around (like used needles that can’t be safely removed), call 911 and follow the operator’s instructions.
If you’re safe, follow these steps:
- Check the person for signs of opioid poisoning.
- Check if they’re awake. Call 911 right away if you can’t wake them up by talking loudly or by rubbing up and down on their chest with a closed fist. Follow the operator’s instructions.
- Check if they’re breathing. Listen for breath, feel for air leaving their nose, and watch their belly and chest to see if they move.
If they’re breathing, put them in the recovery position: Roll them on their side. Place their opposite hand underneath their head. Pull the top knee out so they don’t roll onto their stomach.
If they’re not breathing, start rescue breathing. To do this, tilt their head back and lift their chin up. Give 1 rescue breath every 5 seconds for 2 minutes (about 24 breaths).
If they’re not breathing after 2 minutes of rescue breaths, prepare to give naloxone.
- Prepare naloxone by following the instructions in the naloxone kit.
- Inject naloxone in the middle of the outer thigh muscle or the shoulder muscle at the top of the arm.
- Keep rescue breathing for another 2 minutes, if they’re not awake or breathing normally on their own.
Give another (second) dose of naloxone if they still don’t respond or breathe on their own after 2 minutes of rescue breathing. Repeat with any extra doses of naloxone if you have any. Keep rescue breathing for 2 minutes between doses until help arrives or the person wakes up or breathes on their own.
If the person starts breathing or responds, place them in the recovery position.
When a person wakes up after poisoning
- Be calm and let them know they’re safe.
- Expect that the person may be confused, surprised, embarrassed, angry, or upset.
- Let them know what happened and that you gave them naloxone.
- Tell them the naloxone stops the opioid from working for a short time so they can breathe again.
- Tell them the naloxone will wear off in 20 to 90 minutes and that someone needs to watch them for a few hours (in case they go back into poisoning).
- Tell them not to use other drugs for at least 2 hours.
- Tell them that help is on the way.
When medical help arrives
Tell the medical team what you saw, what you did, and how much naloxone you gave.
If you need to leave before medical help arrives, place the person in the recovery position. Leave the used naloxone kit with all the vials and needles. Put it in a safe place so the medical team can see how much naloxone you gave.
Where to get naloxone kits
You can get a naloxone kit at pharmacies, walk-in clinics, and other places where you live. You can also visit drugsafe.ca or ahs.ca/naloxone and select “Get Naloxone”.
To see this information online and learn more, visit MyHealth.Alberta.ca/health/pages/conditions.aspx?Hwid=custom.ab_opioids_naloxonekit_inst_adult.
For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: November 30, 2023
Author: Provincial Harm Reduction Services, Alberta Health Services
This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.
